Fulminant gastrointestinal hemorrhage due to Strongyloides stercoralis hyperinfection in an AIDS patient

Bollela, Valdes Roberto; Feliciano, Cinara Silva; Teixeira, André Costa; Junqueira, Ana Carolina Ribeiro; Rossi, Marcos A.

doi:10.1590/0037-868215522013

Cited by 16 publications

(6 citation statements)

References 10 publications

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“…Thus, strongyloidiasis can be considered an opportunistic infection with an AIDS-related agent [32]. The depression of cellular immunity is the conditioning factor for spread of strongyloidiasis [33,34].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Parasitic Infections in HIV Patients Parasitic Infections in HIV Patients

Er¹,

Lmr²,

Rlg³

et al. 2019

BJSTR

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Individuals with Human Immunodeficiency Virus (HIV) have a predisposition to opportunistic infections. This study aimed to determine the prevalence of parasitic infections in patients with HIV/AIDS, attended at the Joint Health Unit of Taguatinga in the Federal District, Brazil. Field research of cross-sectional, quantitative and exploratory character was conducted. Data were collected from patient records available in the Archival System of the Health Unit from 2005 to 2015. We analyzed 502 medical records of patients with HIV/AIDS: 307 men and 195 women. 158 men and 71 women were homosexual, 68 men and 01 woman were bisexual, and 21 men and 9 women had not sexual preferences. 419 patients did not have parasitological or serological tests performed after HIV infection. Among those who had been tested the parasites detected were: Ascaris lumbricoides, Entamoeba histolytica, Giardia lamblia, Strongyloides stercoralis, Trypanosoma cruzi and Toxoplasma gondii. The commensal Entamoeba coli were also found. The reduced helminths number and pathogenic protozoa found is due to small number of tests performed. So, it is necessary to increase requests for parasitological examinations in this population to prevent comorbidity enteroparasites and HIV infections, improving the quality of life of these patients.

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Section: Discussionmentioning

confidence: 99%

Correlation between Parasitic Infections in HIV Patients Parasitic Infections in HIV Patients

Er¹,

Lmr²,

Rlg³

et al. 2019

BJSTR

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“…At the same time, although strongyloidiasis was once considered an AIDS-defining illness, there is no evidence that a low CD4 will increase the risk of dissemination or decrease the chance of clearing an infection [9,10]. However, recent series and case reports show the opposite -that HIV is an actual risk factor for strongyloidiasis in immunocompromised patients [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Severe Strongyloidiasis With Negative Serology After Corticosteroid Treatment

Rodríguez¹,

Abraham²,

Williams³

2014

American Journal of Gastroenterology

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Unusual clinical course Background: Strongyloidiasis usually presents as a chronic and limited disease, but in some immunocompromised patients it may become a life-threatening disease. Case Report: A 77-year-old Haitian male, with history of temporal arteritis on 40 mg of oral prednisone presented complaining of decreased oral intake, epigastric pain, and non-bloody diarrhea. He had bi-temporal wasting and a distended abdomen but without guarding or tenderness. Laboratory examination included mild leukocytosis, anemia, negative HIV antibody, negative parasite stool exam, and negative serology for Giardia and Strongyloides. CT of the abdomen showed multiple distended loops, without obstruction. During the admission he had a 4 g hemoglobin drop and a positive occult blood test, requiring blood transfusions, IV pantoprazole, and upper endoscopy. Findings included severe duodenitis, blunted villi, and intramucosal and luminal helminthic worms and eggs. Pathology showed Strongyloides stercoralis infection, confirmed by subsequent PCR. He was given 1 day of 15 mg oral ivermectin, diarrhea resolved, and was discharged with a percutaneous endoscopic gastrostomy tube because of the persistent lack of appetite. Conclusions: Given the persistent nature of strongyloidiasis and its high susceptibility to ivermectin, it potentially would be worth consider treating high-risk patients in the appropriate clinical and epidemiological setting, irrespective of screening test results, in order to avoid false-negative result consequences.

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“…Immunosuppressed patients, including kidney allograft recipients, patients with human T-lymphotropic virus (and HIV) infection, and patients using corticosteroids (Fodeman et al, 2010;Bollela, Feliciano, Teixeira, Junqueira, & Rossi, 2013) are particularly at risk of hyperinfection. Recent reports illustrate that afflicted individuals may lack the typical risk factors for strongyloidiasis and may have never travelled to a known endemic region (Alvarez Arango et al, 2016).…”

Section: Strongyloides Infections Can Masquerade As Other Inflammatorymentioning

confidence: 99%

The severely under‐recognized public health risk of strongyloidiasis in North American cities—A One Health approach

Jariwala

Redding

Hewitt³

2017

Zoonoses and Public Health

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Strongyloides and other soil-transmitted helminths represent a severely under-recognized zoonotic public health risk, especially in North American cities. They are present throughout North America, including in urban areas, causing morbidity and mortality in human and non-human animals. Epidemiological "masking" of strongyloidiasis due to overlapping symptoms with other systemic diseases, including allergies, and diagnostic limitations complicate our understanding of the epidemiological extent of this disease, and auto-infection allows long-term persistence of individual infections. Zoonotic transmission and environmental transmission are critical components in the epidemiology of strongyloidiasis, and other diseases caused by soil-transmitted helminths. In this review, we bring together medical, veterinary and environmental expertise in a "One Health" context, to document and analyse this under-recognized risk. We also present implementable opportunities for action with respect to diagnostics, treatment, community engagement and land management to mitigate the impact and transmission of strongyloidiasis and other diseases caused by soil-transmitted helminths.

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Fulminant gastrointestinal hemorrhage due to Strongyloides stercoralis hyperinfection in an AIDS patient

Cited by 16 publications

References 10 publications

Correlation between Parasitic Infections in HIV Patients Parasitic Infections in HIV Patients

Correlation between Parasitic Infections in HIV Patients Parasitic Infections in HIV Patients

Severe Strongyloidiasis With Negative Serology After Corticosteroid Treatment

The severely under‐recognized public health risk of strongyloidiasis in North American cities—A One Health approach

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